Why Leisure-Time Physical Activity Is Irrelevant

Thursday, October 13, 2011

One of the most popular public health measures to combat the obesity epidemic is to promote leisure-time physical activity – the notion being that leisure-time activity could prevent obesity and substantially improve the health of the population.

And, there is certainly no doubt, that one may well imagine that all the joggers and fitness enthusiasts, who we see regularly partaking in leisure sports, must have a substantial impact on population health – even when, in reality, they represent a vanishingly small proportion of the ‘at-risk’ population (I have previously suggested that if all Canadian marathon runners never ran a marathon ever again, there would likely be no discernible impact on population health. No one would notice – except orthopedic surgeons and chiropractors perhaps).

Based on their analysis of domain-specific hours of activity and energy expended among 15,591 participants in the Tomorrow Project, a prospective cohort of adults followed between 2001 and 2005 in Alberta, Canada, the primary activity-related energy expenditure in all ‘very active’ women and amongst all men, except those classified as ‘inactive’, was their occupational activity.

In addition, amongst ‘inactive’ men and women in the ‘active’, ‘low active’ and ‘inactive’ groups, activity-related energy expenditure from household activity was comparable to, or exceeded that for occupational activity.

Thus, not only did leisure-time activity-related energy expenditure decrease with decreasing physical active levels, but, even amongst the most active men and women it accounted for less than 10 percent of total energy expenditure.

Also perhaps, knowing that Alberta is one of the most car-dependent of all Canadian provinces, transportation-related activity was negligible across all categories of physical activity levels and employment status.

A ‘glass-half-empty’ perspective, would suggest that ANY increase in leisure-time physical activity amongst Albertans would prove a substantial relative increase in physical activity of the population.

On the other hand, a ‘glass-half-full’ look at these findings, would suggest that the overwhelmingly vast majority of Albertans will get their physical activity at work or not at all.

The latter makes sense, as we have originally evolved the ability to be physically active primarily to hunt, gather, fight, flee and reproduce. The notion that any reasonable person would actually engage in a significant amount of ‘non-utilitarian’ (read: useless) physical activity beyond early childhood, when play (as in all species) is really only nature’s way of helping us develop physical skills needed for hunting, flighting and flighting, or in adolescence and early adulthood, where physical prowess will increase our likelihood of finding the most desirable mate, is something that physical education enthusiasts (and governments) would wish for, but nature failed to put into our genes.

Indeed, it appears that there is a vanishingly small proportion of our species, which in adulthood will ‘voluntarily’ maintain any relevant level of ‘leisure-time’ physical activity – most will simply (and sensibly?) rest till occupational duty or household chores call again.

“For the inactive portion of this population, active non-leisure activities, specifically in the transportation and occupational domains, need to be considered for inclusion in daily routines as a means of increasing population-wide activity levels. Environmental and policy changes to promote active transport and workplace initiatives could increase overall daily energy expenditure through reducing prolonged sitting time.”

The idea that ‘education’ or ‘tax-incentives’ will ever get enough of the population voluntarily engaging in a meaningful amount of leisure-time physical activity is naive at best.

When Pheidippides, ran from Marathon to Athens, he was not seeking a runner’s high or working on his personal best time – he was merely carrying news of the Persians’ defeat to the capital.

Similarly, the original purpose of the Olympics was not to improve health or prevent heart disease but to demonstrate competencies in physical skills relevant for hunting, fighting and flighting (not to mention that winning a medal would perhaps also up your dating game).

Yes, there is a small proportion of the population, who (strangely enough) continues to enjoy leisure-time physical activity well into adulthood. The vast majority, however, prefers to much rather spend their leisure time reading, playing a musical instrument, engaging in arts and crafts, or simply lying on the couch watching professional sports. This is perfectly reasonable and completely normal human behaviour.

Nature has not designed us to enthusiastically enjoy spending hours everyday on treadmills going nowhere. But, if you have to run to catch the bus as your only means to get to work, you may just quicken your step; if you do have to walk across the room (or even to the next floor) to collect your printouts, you may actually get up and do it.

That is the difference between ‘utilitarian’ and ‘non-utilitarian’ physical activity – the former you have to do – the latter you don’t.

So the question is really not how to get more people to be active during their leisure time – the real questions are how to reintroduce physical activity to the workplace and how to promote active transportation – that may prove to be a far greater challenge than getting people to eat less.

19 Comments

Roberta

Thursday, October 13, 2011

An excellent article. I’ve long since given up going to the gym, but I am a utility cyclist and it certainly has helped me maintain a healthy weight. I’d love to see more emphasis on active transportation – even something as simple as improving bike parking and supplying package and coat checks in stores would be very helpful. But it’s an attitude shift. I’m spending a year in Germany now and what I love about biking here is NOT the bike paths (they’re awful to actually ride on), it’s the expectation that people will cycle to school, to shopping, to church. It’s fantastic to be just another Radfahrer, instead of some freakish slightly sweaty person with a helmet and a backpack. At my daughter’s parent night at school I counted more than 30 bikes. The parents rode to school for the meetings. In my 7 years as a school parent in Canada, I’ve NEVER seen another bike at a school event.

Boy, that certainly fits with my experience. When I started working a high activity job, one which required me to be on my feet all day long, running back and forth in a large store, I lost close to 50 pounds in a couple of years without even trying. Conversely, when I moved to a sedentary desk job, I gained it all back.

I fully agree with the idea of promoting utilitarian physical activity, not only for the direct health benefits, but also for the environmental co-benefits of active transportation, especially in Canada where less than 8% of the population uses active transportation to work…

However, the fact that most people do not spontaneously engage in high amounts of leisure-time physical activity does not offset the benefits of this type of physical activity for those people who do it (increase in fitness, decrease in the risk of depression, diabetes, cardiovascular diseases, cancers, all-cause mortality, etc.). It may not have a tremendous impact of body weight, but weight is not the whole story. Thus, leisure-time physical activity is not irrelevant, it has many benefits, but it’s just not THE solution for the obesity pandemic. This nuance is important – we certainly don’t want to encourage people to spend their leisure time in front of the TV!

As someone who works (passionately) to promote (leisure-time) physical activity participation, I find this article insulting and offensive. Once again you’ve painted a bleak and miserable picture for promoting physical activity and exercise (“Move More”) as a sensible solution or step to obesity prevention and treatment. You continually endorse obesity to be an overly complicated, hopeless situation when really it is a fundamentally simple one. Obesity is nothing more than a (gradual) imbalance of energy: Increased intake and decreased expenditure. Call me naive and simple-minded but IN GENERAL this is true; how can one argue with the laws of physics?! The solution is equally straight-forward: decrease intake and increase expenditure. Unless you are trying to do one of those two things, you are essentially doing nothing to help the situation. While no one seems interested in promoting decreased food intake, at least there are exercise scientists who are devoted to increasing the expenditure side of the equation. Increasing occupational and transport-related physical activity is as good as any place to start, but stating that leisure-time physical activity is irrelevant is unfounded and ultimately unhelpful. It might not reduce rates of obesity (and certainly not right away), but it will certainly increase cardiovascular and general fitness, which are far more important determinants of health, than weight alone.

“The vast majority, however, prefers to much rather spend their leisure time reading, playing a musical instrument, engaging in arts and crafts, or simply lying on the couch watching professional sports. This is perfectly reasonable and completely normal human behaviour.”

As long as you can’t eat and do your hobby at the same time, I think that’s the biggie, whether it involves sweating or not. Most of what people do for fun can be done with a doughnut in the other hand, which is a problem. Running, biking, playing a piano, and some other things can’t be. I think that’s the big win from this sort of thing. Most people’s leisure activities, like reading, watching TV, and handcrafting, don’t require both hands or can be easily interrupted to take a sip of soda or grab a chip. And sports gets you out of the house and away from the fridge.

Whatever you do for fun — do it away from the fridge and make sure it uses both hands. The stairstepper in the dining room is four steps from the freezer where the ice cream is, the knitting needles can be dropped every five stitches to grab a dorito, and a book can be propped up in front of a full plate. Whether sweat and special sneakers is involved is irrelevant.

I had long been puzzled about why I needed someplace to go to go for a walk–just going for a walk was too weird. This article just opened my eyes. Walking up to the hospital for non-fasting blood work seemed normal, so did walking back home, the study should look at those individuals like me who are on AISH( assured income for the severaly handicapped) and see if practical excerise and walking for transportation is greater than the base population. Because low income people usually work jobs that are higher in activity than higher income people do the lower income group may esque this comparison. Real pratical information–Thanks

I really appreciate the thoughts you have expressed in this article. I have not heard this sentiment ever articulated before and it makes perfect sense to me. Professionally, I am a letter carrier. I hike for over 3 hours a day carrying as much as 35 lbs of mail at a time. But on my weeks off, while I want to go be active such as taking a hike in nature, I just don’t. I get more done around the house while I am not working because I have more energy, my inclination is to lay low and not be super active.

At least now I know why!

ps. I wanted to tell Dan, a previous commenter, that I was a letter carrier at 290 lbs. Even being super active for my work I still did not lose a lot of fat. I have subsequently had gastric bypass surgery and have lost over 135 lbs. Yes, I was fit, but exercise wasn’t going to help me not be obese – infact I am still obese even after the weight loss.

If I could bring my dog to my office downtown, or even a to a doggy daycare close by, I would walk him there and back two or three days a week and gladly pay for his day of playing with the other dogs. I’d much rather put money into doggy day care that I can walk to, than a gym membership. I agree that if everyone is biking or walking it makes it much easier to join the crowd.

These are all helpful comments – just wanted to dispel the notion that I do not appreciate the importance or non-weight-loss benefits of physical activity – I certainly do and have blogged about these before.

The point here is that from an ‘effectiveness’ perspective trying to get more people to be more active during leisure is probably a much less promising approach than trying to promote occupational or transportation related activity.

I am not against exercise and anyone, who enjoys this – good for you!

it is just not a solution for people who don’t enjoy exercise or sports (or at least not enough to commit valuable and scarce leisure time to it).

This post is not about ‘efficacy’ of exercise in improving health (no argument there) – it is about ‘effectiveness’ of our approach to increase PAL of the entire population.

This is why I’ve made an effort to get jobs that I can walk to or take public transport to. I’ve spent most of my adult life walking an hour a day in the process of getting to work and back. I often grocery shop on foot, as well. This is part of the reason why I think cities with good public transport are healthier, more sustainable places to live than suburbs. I like to own a car, but I also like to not need it every day.

I’ve always been shocked that many studies on health, exercise and obesity specifically exclude all non-recreational physical activity. Does exercise suddenly not count because you’ve structured it into your life? My theory is that while recreational exercisers are more likely to be thin, people with active jobs and people who get to work under their own steam are more likely to be poor, and therefore also more likely to be fat. That messes with the generalizations about body size and activity level that the researchers want to make.

Thumbs down? Who is it exactly that thinks walking to work is bad or who thinks that paid physical work and commuting by foot (or bike) shouldn’t count as exercise? Seriously? Or is there just someone out there who always give my posts a thumbs down on principal because they don’t like HAES or think that it’s unacceptable for a fat person to think they’re okay at their present size? Or is it someone who thinks the suburban lifestyle is the pinnacle of human achievement? I’m really curious.

Like the poster above, I live in Germany and the town where I live is structured in such a way that walking and biking are much better options than anything involving fossil fuel. Not only that, but there is a culture of hiking – if you’re not prepared to get out on a weekend and go for a hike, you’ll face a certain degree of social disapproval.

But for all the exercise I do, nothing – nothing! – beats shopping. I wear a pedometer and when the Christmas sales are on, my daily step count soars. Hunting and gathering really takes it out of you. If you get the environment and rewards right, the exercise automatically follows!

I’m a lawyer so I have a sedentary job but I take the Metro to my work in downtown Washington. Some days the most exercise I get is walking from the garage to the Metro station and then walking from the Metro station to my workplace and the same on the way home. It is certainly not sufficient but it is a lot more than if I drove all the way to work. I do go to the gym but only 1-2 times per week.

I haven’t read the studies in this area, but what you are saying certainly resonates with my personal experience and what I observe the average person doing. Most people are not going to go to a gym and work out. That seems obvious. It is great for those who do, but as a strategy for population health it is not going to do much.

I have been considering buying a small contraption with pedals that you pedal while sitting at your desk. Have you heard of that?

Arya, you’re better than this. You fight the good fight every day against bias, stereotypes and superficial thinking.

I therefore would expect you to make your very good primary points without distracting us with snarky, dismissive and superficial sidelong comments about people who are in fact active during leisure hours:

I must say I agree with Leslie Nolan. Your characterisation of runners and other exercise enthusiasts (notice I didn’t say “fitness freaks”) is disappointingly dismissive. What’s wrong with seeking a runner’s high, working on your personal best, or using a treadmill?

@ Leslie Nolan and RedPanda: Sorry if my ‘sarcastic’ comments were not appreciated – I have absolutely nothing against anyone who runs marathons, uses their treadmill, seeks a runner’s high or works on their best time – as long as they enjoy it.

My post was about the fact that none of this is likely a realistic solution to get enough people moving to significantly influence population health.

Imagine if playing an hour of violin per day was good for your health – I don’t think we could get enough people in the population to play an hour of violin everyday either (and enjoy it).

The easiest (and probably most effective way) to get the population to move (or to play the violin) would be to make movement (or playing the violin) part of what ‘they have to’ do (to earn a living or keep their house tidy) rather than something “they chose to’ do just because it’s fun (to many people neither running nor playing a violin is fun).

That’s all – I have as much respect for anyone who choses to spend their leisure-time running as I have for those, who chose to spend their leisure time honing their violin skills – I also understand why most people ‘chose to do’ neither.

My city, Canberra, Australia, has been designed for exercise. There are bike/running paths, hiking trails, and expanses of natural bushland throughout the city (in fact, it’s often called “the Bush Capital”, not because it’s in the bush, but because it has been built in and around the bush). There are even bike racks on the front of the buses so that people can ride/cycle to work or university if they choose. But despite all that, precious few people take advantage of the amenities.

My husband and I don’t own a car, so we commute by bus, getting a bit of incidental exercise every day. Our end of town is quite flat, so every Saturday we take the bus to the other end of town which has steep hills, vast tracts of both natural bushland and parkland, and miles of hiking trails. We can be out hiking all day and never see another human being. It’s quite depressing.

I’ve got to admit that i was a little surprised as well. Call it regional variance or something else, but down here in good ol’ southern california, there’s a pretty large demographic of individuals who are pretty serious about their health and non-occupational activity.

As our occupations become less physically demanding, there are some folks out there that feel a need to get more exercise. Some of them actually LIKE it. But then ultimately, we’re all wired differently.